Individual provider Active NPI

Gary William Tamkin, MD

  • Emergency Medicine Physician
  • Oakland, CA
National Provider Identifier
1205816113
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G78338 Issued in CA
Practice address
1411 East 31St St
Oakland, CA 94602-1018
Phone
(209) 342-2300
Fax
(209) 524-4240
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G78338 CA Primary

Addresses

Primary practice location

1411 East 31St St
Oakland, CA 94602-1018

Mailing address

4301 North Star Way
Modesto, CA 95356
Phone (209) 342-2300

Other identifiers 1

IdentifierTypeStateIssuer
00G783380MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505000738 CA Practitioner - Emergency Medicine 1052309200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G78338CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Emergency Medical Associates Emergency Medicine CurrentSince May 1, 2011 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1205816113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTH STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95356",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 EAST 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMKIN",
        "first_name": "GARY",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G78338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G783380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.